Maternal healthcare services use in Mwanza Region, Tanzania: a cross-sectional baseline survey

James Orwa,Sharon Brownie,Secilia Mrema,Grace Edwards,Micheal Mugerwa,Leonard Subi,Kahabi Isangula,Marleen Temmerman,Columba Mbekenga,Eunice Siaity Pallangyo,Tumbwene Mwansisya,Loveluck Mwasha,Michaela Mantel,Edna Selestine,David Siso

doi:10.1186/s12884-019-2653-4

Abstract

BackgroundImproving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania.MethodsA cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables.ResultsOf the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups.ConclusionUse of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.

Highlights

Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals
The findings showed that the percentages of women who attended ANC4+ visits and delivered in health facility were higher than the findings from the Tanzania Demographic Health Survey (TDHS) 2015–2016 for Mwanza Region [3]
The proportion of health facility deliveries was comparable with that in Mbarali District, Tanzania, where 70% of women delivered in a health facility [16]. The analysis of these results indicated that the efforts of the Government of Tanzania and other partners in improving access to Maternal healthcare services (MHS) services appeared to positively impact the coverage of ANC4+ attendance and health facility deliveries

Summary

Introduction

Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. There has been a decline of 45% per year since 1909 in maternal deaths and about 289,000 deaths estimated in 2013 [1]. Orwa et al BMC Pregnancy and Childbirth (2019) 19:474 eclampsia, which are detectable through attending antenatal care (ANC) services, along with indirect causes such as distance to health facilities [5, 6]. Maternal healthcare services (MHS), including ANC, health facility delivery, and postpartum check-ups, can play an important role in the reduction of maternal mortality and morbidity and remain pillars of safe motherhood [8].

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